» Vision News

Dr. Nate’s TV News Segment About Children’s Vision and VSP’s EyePledge program

Dr. Nate — Mon, 17 Oct 2011 15:44:46 +0000

It is not everyday that a television news crew comes to Bright Eyes, so when we were given the opportunity we were very excited. We got to the office extra early and made sure everything was ready. The subject was children’s vision and the importance of annual eye exams for kids. Children can have a variety of vision problems that interfere with learning, including difficulty seeing clearly, problems focusing and moving their eyes, and difficulty making sense of what they see. For some children, glasses are sufficient to solve their visual problem. For others, Vision Therapy, a series of therapeutic activities, is necessary to ensure the eyes are working properly.

The video also goes into detail about the excellent program called the Eye Pledge that for every Eye Pledge taken, VSP Vision Care will donate an eye exam and a new pair of glasses to a child served by the Boys and Girls Club – up to 50,ooo children. The Eye Pledge is easy to take and doesn’t cost you a thing! Take the Eye Pledge now and help a child. One of the great things about it is that you can specify if you want the donation to go to a child from a Boys and Girls Club in your area or to an area with the greatest need.

To read more and take the Eye Pledge visit: http://www.seemuchmore.com/take-the-pledge

Has your child had an eye exam? They should be a standard part of the Back to School Checklist! If you have questions about children’s vision or children’s eye care, do not hesitate to call us at 813-792-0637.

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

E3 Special Event: EmPower Electronic Eyewear

Dr. Nate — Fri, 30 Sep 2011 15:57:04 +0000

Check it out!

We wanted to let you know about an exciting new advancement in vision, now available at Bright Eyes Family Vision Care. We are one of the first few offices in the country to bring this amazing eyewear technology to our patients.

emPower lenses give you CONTROL of your vision! With a swipe of your finger or a tilt of your head, you control the focusing power of this revolutionary progressive lens!

While you are free to come check out the emPower lenses now, we hope that you will consider joining us for a special event!

Join us on Thursday, October 13 from 5:30-7:30pm.

E3 Special Event: EmPower Electronic Eyewear

Try the new lenses for yourself and Save 25% to 50% this one night only!

Space is limited so Email or call to or use Facebook to RSVP early for this special event!

AOA School Readiness Summit: Focus on Vision

schoonover — Wed, 08 Jun 2011 14:06:35 +0000

The American Optometric Association recently held a School Readiness Summit: Focus on Vision in which doctors, nurses, educators and advocates for children’s health gathered to examine learning-related vision issues that are keeping children from achieving in the classroom. This summit was created to address the concerns that our current system is flawed and a policy shift is needed. The problem is that currently, the U.S. educational system and some health care providers rely heavily on vision screenings to discover the kids that need comprehensive exams. These screenings do catch some types of vision problems but they can miss about 75% of those children that have learning-related vision problems. Detecting these vision problems is very important as “studies show that much of what children learn comes though vision, and undetected and untreated eye and vision disorders in children, such as amblyopia and strabismus, can result in vision loss, additional costly treatments, delayed reading and poorer outcomes in school.”

The take-home statement that the summit produced is that comprehensive eye exams must serve as the foundation to determine school readiness in school-aged children. Another important point established at this meeting is the establishment of the link between healthy vision and classroom learning.

This historic summit is an important step in ensuring that children receive the proper detection and treatment of vision problems before they become detrimental to their learning. Here at Bright Eyes Family Vision Care, we are excited to see these changes being made, since it has been our goal from the beginning to not only catch vision problems at an early stage, evidenced by the InfantSEE program that we offer that provides free eye exams to infants between the age of 6 months and 1 year of age, but to also treat certain types of problems through our extensive one-on-one vision therapy program.

If you have any questions regarding the InfantSEE program, vision therapy program, or would like to schedule a comprehensive eye exam for your child before they start school, give our office a call or come in to schedule.

All the best,

Justin Schoonover, CPO

Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Happy Orthokeratology Patients at Bright Eyes

Dr. Nate — Mon, 09 May 2011 02:29:43 +0000

Orthokeratology goes by many names…. Ortho-k, corneal refractive therapy, Gentle Vision Shaping, corneal molding, and others. At Bright Eyes Family Vision Care, we tend to call it corneal reshaping or Orthokeratology. But regardless of whatever terms we choose to call it, our patients call it “awesome!”

Watch for yourself:

(Click here to watch on Youtube).

This last weekend I was fortunate enough to attend and speak at the Orthokeratology Academy of America (OAA) educational conference. The OAA is an international organization of orthokeratologists who provide a nonsurgical alternative to refractive surgery for nearsightedness, astigmatism and hyperopia. Current research also shows that Ortho-K can slow myopic progression in children.

The international faculty of presenters covered topics including myopia control (including soft lens technology), corneal reshaping research, safety of corneal reshaping, progressive/hyperopic Ortho-K lens designs, new corneal reshaping techniques. I heard speakers from Australia, Japan, China, Italy, Spain, and from all over the US.

President Dr. Cary Herzberg had the pleasure of announcing the inception of the new International Academy of Orthokeratology(IAO). The IAO brings together ortho-K organizations from the America (OAA) as well and Europe and Asia. This international organization will support, promote and advance corneal reshaping worldwide thru quality education and research presentations at meetings held around the world. For more information about the OAA click here.

At Bright Eyes, we have successfully treated patients from 7 to 59 years old with orthokeratology. This includes pilots, lawyers, retirees, and lots of kids like Christopher (above). If you would like more information about Orthokeratology, call our office in Westchase at 813-792-0637 or visit http://BrightEyesOrthoK.com

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

An Optometrist’s Review of the Nintendo 3DS

Dr. Nate — Tue, 29 Mar 2011 17:59:01 +0000

For months, I’ve been reading, writing, and speaking about the Nintendo 3DS, all without actually seeing or using it. I was finally able to change that yesterday. After helping put the kids to bed, I slipped off to Best Buy and purchased a shiny black 3DS. I brought it home and Cristina and I spent a few hours setting it up and using it. We’ve had a Nintendo DS at Bright Eyes for years that we use as a reward activity during vision therapy, so it was immediately very familiar.

3D Effects

One of the biggest selling points of the 3DS is that the user does not need to wear special glasses to see the 3D effects. This is called autostereoscopic 3D and is definitely where 3D technology is going. It works surprisingly well, considering the small screen. You do have hold the screen flat relative to your head. If you angle the screen, you will either see double or lose the 3D effect. The 3D does work from positions other than dead-center. This means that, while not ideal, it is possible for more than one person to see the 3D effect at one time.

I was particularly interested to see how well the “3D volume” slider worked. This allows users to adjust the amount of 3D shown to suit their tastes and the particular game. It works amazingly, seamlessly well. I was able to adjust the 3D anywhere from none, to just-noticeable, to full with just a flick of my thumb.

Augmented reality

One of the most intriguing aspects of the 3DS is its use of AR (augmented reality) as part of the game. This allows the viewer to play the game within the room or area that they are really in. (See picture to the right). Not only is this extremely fun, there are some potential visual benefits to this. If the game is getting further away, it is more likely that the user will hold the game further away and look further away, potentially reducing some strain on the eyes. (I should note that I don’t have any research on this, but it occurred to me while playing.)

3DS vs. DS

One of the biggest visual concerns with 2D game systems such as the original Nintendo DS is that children tend to hold the screens incredibly close – as close as 3 or 4 inches. A person of any age should not hold a book or game closer than their Harmon Distance (or the distance from the knuckle to the elbow). With the 3DS, the 3D effect is better when the game is held a foot or so away from the eyes, so this will naturally encourage users to stay within their Harmon distance.

Safety

Much has been made, appropriately, of the potential adverse effects of using 3D technology, due to the differences of 3DS and real-life 3D. Nintendo’s official warning of “vision damage” occurring for those six and under has gotten a lot of attention. While I haven’t seen any proof of this, I think it is reasonable because a person has to pretty visual sophisticated to use the 3DS. So I do recommend keeping it away from the young kids. They should be building with blocks and playing outside anyway,

For the older kids and adults (like Justin, on the left) who use the 3DS, eyestrain is possible. Already, I’ve talked to patients who have experienced headaches, nausea, and blurred vision from the 3DS. I’m happy to report that after an hour neither Cristina nor I experienced any of these symptoms. However, we routinely do activities during vision therapy that require visual skill and flexibility. For that reason we are much more accustomed to the visual demands required by the 3DS.

The #1 thing to remember: moderation. Take frequent breaks, even if you feel OK. Use the 20/20/20 Rule – Every 20 minutes, look away from the screen at something 20 feet away for at least 20 seconds. Even Nintendo recommends that players take a 10 minute break every hour.

If you or your children do experience symptoms, or don’t see the 3D even with the 3D on “full” be sure to get a through eye exam to look for vision or eye coordination problems. And remember that eye exams are recommended at age six months, three years, and before kindergarten.

For more on potential health effects of the Nintendo 3DS, see my interview with PCWorld. See also the American Optometric Association’s press release on the subject

Overall

In summary, the Nintendo 3DS easy to use and fun. The 3D effects are effective and being glasses-free is very nice. The augmented reality really works well. When used in moderation for the appropriate ages, I do not see any harm. If you do have concerns, schedule an appointment at Bright Eyes either on our webpage or calling 813-792-0637.

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Top Ten New Year’s Resolutions for Computer Vision Syndrome

Dr. Nate — Sat, 01 Jan 2011 16:13:38 +0000

If 2010 has taught me anything, it is that our lives are becoming increasingly digital. Not only is more of our work performed on computers and online, but much of our leisure time, too. This is illustrated by the fact that Amazon has recently announced that it has sold more Kindles than any other book or product. But all of this time in front of screens can take its toll on our eyes. They may become irritated and red. Your vision may become blurry or double. And all this may make you less productive at work or reduce your gaming performance. All of these symptoms are elements of Computer Vision Syndrome (CVS). Fortunately, there are things that you can do limit the effects of CVS.

Every new year I provide the Bright Eyes Family Vision Care Top Ten New Year’s Resolutions. In past years, I’ve covered eye health, children’s vision, and saving money. So for 2011, to help you keep your eyes in optimum condition at the computer or digital device, this year’s resolutions list will help you combat Computer Vision Syndrome.

1. Take Breaks – Your eyes work hard when using the computer, e-readers, and phones. Give them some time to relax. Use the “20-20-20 rule.” Every 20 minutes, take a 20-second break, and look at something 20 feet away. Every hour or so, talk a longer break. I use and recommend a free application called Workrave that is fully customizable to help you remember to give your eyes (and hands) a rest.

2. Monitor Settings – Today most people have LCD screens. Generally, the larger the screen the better. Increase the font size if it helps.

3. Monitor Position – Position your monitor at least 22 inches away and at an angle that you don’t have to look up most of the time. Making it a natural, comfortable position can help limit eyestrain and neck problems.

4. Blink! – Research studies show that people blink less when using the computer, up to 1/3 less. Blinking washes your eyes in naturally therapeutic tears, so be sure to blink on a regular basis.

5. Glasses - Make sure you have proper lenses for the computer. Specially prescribed computer glasses may help significantly reduce the symptoms of CVS. Often these are different from glasses for driving and general activities like shopping. Ask your optometrist if you would benefit from computer lenses.

6. Lighting – Keep bright lighting overhead to a minimum. Keep your desk lamp or window light shining on your desk, not on your monitor. Try to keep window light off to the side, rather than in front or behind you.

7. Position your chair - Your body position effects your eye position – and vice versa. Make sure you are sitting in a chair with adequate lower-back support. Position your chair so that you are comfortable. Each person has a preference for his or her chair, so take some time to find what’s best for you.

8. Eye exams – Be sure to discuss CVS with your optometrist at your annual eye exam. He or she will discuss your computer use and can perform specific tests to determine if you would benefit from computer glasses, eye drops or medical treatment.

9. Gadgets – iPads, Kindles, Blackberries and other mobile devices are hugely useful, but have tiny screens and can cause even more symptoms than a desktop computer. Be aware of issues like glare and be sure and take frequent breaks.

10. Don’t forget the kids! – Keep in mind that children can experience CVS, too. And they are less self-aware and are less likely to tell parents if they are having problems. So set limits ahead of time and watch them for any signs of visual problems. This applies to hand-held games, too – especially soon to be released Nintendo 3DS.

If you didn’t have a thorough eye exam in 2010, don’t put it off any longer. Give us a call at 813-792-0637 to schedule your appointment. We’ll make sure your eyes are working their best at the computer! You can also read more about Computer Vision Syndrome on our blog.

A special thanks to Dr. Jeffrey Anshel of Corporate Vision Consulting for providing input for this list.

See Well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

A Warning about the Nintendo 3DS and Childrens Vision

Dr. Nate — Fri, 31 Dec 2010 03:33:07 +0000

Today there has been a lot of discussion about an unreleased hand-gaming system cleverly called the the Nintendo 3DS. The system is similar to the popular Nintendo DS, which has a small touch-screen, but the 3DS allows users to play games in 3D without the use of 3D glasses.

The DS can be a lot of fun and can even be used as therapy in some cases. However, its tiny screen and close viewing can cause eye fatigue, blurry vision, headaches, and discomfort with prolonged use. The best advice is to hold the game at Elbow Distance and take frequent breaks.

Not surprisingly, the new 3DS can provoke similar visual symptoms. Today, both CNN and the LA Times have both reported on the warning that Nintendo itself released:

“Vision of children under the age of 6 is in the developmental stage. Nintendo 3DS, 3-D, including 3-D movies and television, delivers 3-D images with different left and right eye images, which has a potential impact on the growth of children’s eyes.” (translation)

It is true that young children are still developing visual skills (adults do as well, just not as quickly) and it is likely that intense near work plays a role in the development of myopia or nearsightedness. So it is a good idea to minimize the amount of time young children spend on any near task, whether it be 2D or 3D. Playing outdoors is a great alternative.

For older kids and adults, the 3DS is probably a lot of fun. I definitely will try it out. But remember, as always, moderation is important. Take breaks every 20 or 30 minutes. If your eye doctor has prescribed glasses for reading, use them while playing. And if you do experience headaches, blurry or double vision, or other problems after playing the 3DS, be sure to have a thorough eye exam. That could be the indication of more serious problems.

UPDATE: For more info and background, see this VisionHelp post by Dr. Len Press.

See Well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

AOL Story about a Child’s Vision and Learning Success

Dr. Nate — Tue, 28 Dec 2010 16:59:17 +0000

More and more regularly there are stories in the local and national media about vision therapy. This is great because not everyone is aware that vision problems can be responsible for a child having trouble learning to read. Or parents may not know that difficulties with vision can keep a good reader from completing assignments. The more research that is done, books are that published, and news stories are produced, the more likely it is that these patients can get the help they needed.

Just this week there is an article in the AOL Health section called, Could Your Child Have a Learning-Related Vision Problem? It is a story about the problems that Andrew had with reading that were related to vision problems even though he could see 20/20. He was on the verge as being classified as having a “learning disability.” That could be a devastating label for a bright young child to have.

Fortunately, Andrew’s eye coordination problem was discovered and treated by Optometrist Kimberly Walker. He had a “learning-related vision problem,” a problem with eyes and vision that make school harder than it should be. The process for treating these kinds of problems often involves glasses and a series of therapeutic activities called “vision therapy.” Essentially, the goal is to help the patient learn to use their eyes as effectively as they can. This allows them to develop needed life-skills like reading and writing.

If you’d like more information about learning-related vision problems, or to find a doctor who can evaluate for learning-related vision problems, visit COVD. Or feel free to call our office at 813-792-0637.

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Acupuncture for Amblyopia (Lazy eye)?

Dr. Nate — Tue, 14 Dec 2010 15:45:05 +0000

A recent study came out yesterday that has a lot of people talking. Acupuncture may be as effective in treating amblyopia (lazy eye) as patching.

From the CNN story Needles trump patches in treating kids’ eye problem:

In the randomized trial, researchers compared the effectiveness of two hours of daily patching therapy with acupuncture for treating lazy eye in 88 children aged 7 to 12. All children had already worn glasses for at least 16 weeks. 43 of the children were randomly assigned to the acupuncture treatment group, receiving five treatments per week that targeted five needle insertion sites. 45 children in the patch group had their stronger eye patched for two hours per day and were instructed to do activities such as reading and typing, which helps to strengthen near vision in the weaker eye.

What do I think about this? I don’t know. I’m not highly educated in acupuncture. I do think it has it’s place. I do know that patching alone is not as effective as vision therapy because patching treats one eye and not both. (See this recent post by Dr. Len Press for additional info). So it is not compelling that acupuncture is better than patching.

I also know that amblyopia is much more than a visual acuity problem. It is a problem of many visual skills including focusing and perception. So much more extensive research needs to be done. But this is a good sign that ophthalmologists and visual scientists are looking into complex areas of vision and visual treatment.

Before anyone undertakes acupuncture for amblyopia, I do recommend a comprehensive visual and eye health evaluation by an optometrist who specializes in children’s vision. If you need to find one, COVD is a great place to start.

So that is my opinion. What do you think about acupuncture for amblyopia?

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Myopia in the News: A Huge Increase in the US and What Can Be Done

Dr. Nate — Thu, 17 Dec 2009 05:26:20 +0000

My colleagues and I think and talk about myopia (nearsightedness) every day. We talk about the drawbacks (and rewards) of being myopic. We talk about the causes and treatment options for myopia, both short and long term.

But I have never seen a day like today, with myopia in all the papers and on every major TV news program. Given how quickly news travels today, the total number of people thinking and re-thinking about their eyes and vision is probably higher today than it has ever been!

Yesterday morning, I received an email about a newly released study, “Increased Prevalence of Myopia in the United States Between 1971-1972 and 1999-2004.” While I take it as common knowledge that nearsightedness is increasing in much of the world, including the United States, even I was stunned to see this headline about the study: “Myopia Prevalence Rose 66% over 30-Year Period” There is no way around it, a 66% increase is a lot!

So I posted the link on Twitter and Facebook, but I didn’t really have the time to dedicate to the study until today. And then the really big news hit. There are stories on myopia on NPR, Discover, the LA Times, and video segments on Good Morning America and local affiliates such as these and these.

So since this is such a hot topic today, I’ll share what I tell patients almost every day at the office. But first let me say this: while vision science has advanced tremendously, and we have a better understanding than ever, there still is a lot that we do not know about the details of nearsightedness and its development. And, although this may shock you to read, there are some less-than-ethical people who will claim to have all the answers and will say with a straight face that they have THE ONLY WAY to either prevent or eliminate nearsightedness or glasses. The truth is that we don’t know exactly how this works and we can never make promises because what may work for 1000 people may not work for you.

But we can say some things about myopia more generally. There is a genetic component for sure, but just because you and your spouse are nearsighted is not a guarantee that your children will be . In fact, there may be more commonly a genetic susceptibility than an actual myopia “gene.” And clearly there are other factors involved because while the population is changing (due to aging and immigration) our US genes haven’t changed that much in 30 years, but our eyes have!

So, as many of the links above point out, our lifestyle can have an impact on vision. Our eyes are inherently best-suited for looking off into the distance. This is easy and natural. Yet today we spend an increasing amount of time and effort focusing within arms-length and in some cases just a few inches. And while we have always had (and will continue to have, I hope) kids and adults with their noses buried in bound books, the truth is that intensely playing tiny video games or texting does require more visual effort. And I can attest from seeing patients at Bright Eyes that children are engaged in these activities at younger and younger ages.

So – if a patient has increasing nearsightedness, or seems predisposed to be nearsighted what are the options? Here are the refractive options from least to most aggressive.

Do nothing. Some people prefer to not take any action because they do not have need to see better at a distance and they prefer the vision up close. This is totally reasonable, as long as it is an educated choice and not just by default or neglect. However, this is not itself a treatment for myopia and in fact may promote myopia in the long run.
Traditional glasses or contacts. This will help a patient see clearly in the distance which is necessary for things like driving or going to school which are important. But it will not address any underlying problems leading to increasing myopia.
Bifocal Glasses. This method was more popular in prior decades to slow down myopia progression. The scientific studies have not shown it to be as helpful generally, but may be for a subset of people with specific visual problems.
Multifocal soft contact. There is small but growing evidence that multifical contacts, like Proclear EP, can provide clear distance vision and limit the progression of nearsightedness.
Orthokeratology (Corneal Reshaping). There is several scientific studies that have shown that this can provide safe, clear daytime vision, and slow or stop progression of myopia. You can read more about this here. And I have written more about this here.
Atropine drops. This method of myopia control involved the use of prescription eye drops to keep the eyes dilated. This has been used for years and is more popular in Asia, but has not caught on in the US, due to side effects.

But regardless of which method is employed above, it is wise to take frequent, brief breaks from near work. Looking up and away every 15 minutes or so is a good idea, because there is some evidence that it is not the total time during near work, but the length of the individual periods of work that make a bigger difference. Getting outside more is a good idea, but it is not clear if it is the distance vision, sunlight, or some other benefit. Of course, this is true not just for your eyes, but for your body and mind, too!

As vision professionals, we clearly have much work to do in understanding more about why and how myopia occurs. But it is exciting to know that there are treatment options that can reduce the likelihood of progression.

If you have concerns about your vision or if your children have not been thoroughly evaluated, call us at 813-792-0637 to schedule an appointment. After reviewing the examination findings, we can discuss concerns and treatment options that may be right for you.

Be well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

(Edited to fix a few typos and add some info left out).